This report describes a new technique of laparoscopically assisted anorectal pull-through (LAARP) for repair of high imperforate anus. The procedure utilizes minimal perineal dissection, preservation of the distal rectum, and accurate placement of the rectum within the levator ani and external anal sphincter muscle complex. Twenty patients were treated with initial colostomy in the newborn period followed by delayed LAARP later. Laparoscopic mobilization has been possible on all cases attempted. Lack of long-term follow-up precludes accurate assessment of the potential for fecal continence. However, short-term experience has shown that this method of pull-through for imperforate anus offers many advantages, including excellent visualization of the rectal fistula and surrounding structures, accurate placement of the bowel through the anatomic midline and levator sling and minimally invasive abdominal and perineal wounds.